Evaluation of Efficiency and Reliability of Teledermatology

Abstract

Abstract Background Teledermatology (TD) is one of the most rapidly evolving branches of telemedicine. It uses the information and communications technologies to diagnose, monitor, treat, prevent, research, and educate over a distance. It was demonstrated to be more efficient and cost effective in certain settings, such as travel times. It was reported to be reliable and diagnostically accurate for a variety of dermatologic complaints and was shown to reduce wait times, increase access, and improve patient satisfaction and quality of life. Aim of the Work to evaluate the efficiency of teledermatology as a patient-doctor communication channel, as well as its reliability to reach a proper diagnosis of variable skin disorders. Patients and Methods All patients took photos for their lesions and accompanied them with history in their own words, then the clinic dermatologist carried out history taking and face to face examination as well as taking professional photos. The images and history collected by the patients and the clinic dermatologist were assessed by 10 blinded dermatologists. Results of dermatologist presenting cases expectedly showed high percentages of history and photo appropriateness (89.3%, 93.4% respectively) hence high percentage of clue to diagnosis (94.3%). However 35.9% of the cases needed in person evaluation which is still acceptable percent and it could be attributed to the need of further assessment such as clinical, dermoscopic, histopathological examination. On the other hand, the cases presented by the patients were significantly less appropriate than those presented by the dermatologist as regards history and photo appropriateness (31.0%, 31.4% respectively) hence lower percentage of clue to diagnosis (59.1%). And 71.5% of the cases needed FTF consultations. Conclusion TD is a leading subspecialty of telemedicine that continues to evolve with advancements in telecommunications and smartphone technology. The evidence to date supports its accuracy, cost effectiveness and ability to facilitate dermatologic care. It should be considered as a valid alternative for face-to-face consultations. And in these days particularly when social distancing is important; TD must be considered as a critical tool to avoid virus transmission and to save both patients’ and physician’s lives. However FTF consultations will remain the gold standard method for diagnosis especilally in diseases which needs clinical, dermoscopic and histopathological examination.